On the relative importance of bending and compression in cervical spine bilateral facet dislocation

2019 ◽  
Vol 64 ◽  
pp. 90-97 ◽  
Author(s):  
Roger W. Nightingale ◽  
Cameron R. Bass ◽  
Barry S. Myers
Keyword(s):  
Cervical Spine ◽  
Relative Importance ◽  
Facet Dislocation

scholarly journals Surgical treatment for irreducible pediatric subaxial cervical unilateral facet dislocation: case report

2016 ◽  
Vol 17 (5) ◽  
pp. 607-611 ◽  
Author(s):  
Wei Qu ◽  
Dingjun Hao ◽  
Qining Wu ◽  
Zongrang Song ◽  
Jijun Liu
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Complete Resolution ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Facet Dislocation ◽  
Unilateral Approach ◽  
Subaxial Cervical Spine

Unilateral facet dislocation at the subaxial cervical spine (C3–7) in children younger than 8 years of age is rare. The authors describe a surgical approach for irreducible subaxial cervical unilateral facet dislocation (SCUFD) at C3–4 in a 5-year-old boy and present a literature review. A dorsal unilateral approach was applied, and a biodegradable plate was used for postreduction fixation without fusion after failed conservative treatment. There was complete resolution of symptoms and restored cervical stability. Two years after surgery, the patient had recovered range of motion in C3–4. In selected cases of cervical spine injury in young children, a biodegradable plate can maintain reduction until healing occurs, obviate the need to remove an implant, and recover the motion of the injured segment.

Cervical facet dislocation: techniques for ventral reduction and stabilization

2000 ◽  
Vol 92 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Bernardo J. Ordonez ◽  
Edward C. Benzel ◽  
Sait Naderi ◽  
Simcha J. Weller
Keyword(s):  
Cervical Spine ◽  
Surgical Approach ◽  
Plate Fixation ◽  
Neurological Status ◽  
Content Type ◽  
Facet Dislocation ◽  
Cord Injury ◽  
Complete Spinal Cord Injury ◽  
Cervical Facet ◽  
Fine Print

Object. To demonstrate the safety and utility of one surgical approach, the authors reviewed their experience with the ventral surgical approach for decompression, reduction, and stabilization in 10 patients with either unilateral or bilateral cervical facet dislocation. Methods. Six patients presented with unilateral cervical facet dislocation and four patients with bilateral cervical facet dislocation. There were six male and four female patients who ranged in age from 17 to 72 years (average 37.1 years). The level of facet dislocation was C4–5 in one, C5–6 in four, and C6–7 in five patients. Three patients presented with a complete spinal cord injury (SCI), three patients with an incomplete SCI, three with radicular symptoms or myeloradiculopathy, and one patient was neurologically intact. All patients underwent plain radiography, magnetic resonance imaging, and computerized tomography evaluation of the cervical spine. All patients had sustained significant ligamentous injury with minimum or no bone disruption. All patients underwent ventral decompressive surgery, reduction of the dislocation, and stabilization of the cervical spine. Techniques for performing ventral reduction of unilateral or bilateral cervical facet dislocation are described. Decompression, reduction, and stabilization of the cervical spine via the ventral approach was accomplished in all but one patient. This patient underwent a ventral decompressive procedure and an attempt at ventral reduction and subsequent dorsal reduction and fusion in which a lateral mass screw plate fixation system was used; this was followed by ventral placement of instrumentation and fusion. There were no surgery-related complications. Postoperative neurological status was unchanged in four patients and improved in six patients. No patient experienced neurological deterioration after undergoing this surgical approach. Conclusions. The authors conclude that a ventral surgical decompression, reduction, and stabilization procedure provides a safe and effective alternative for the treatment of patients with unilateral or bilateral cervical facet dislocation without significant bone disruption.

Brain Abscess Complicating the Use of a Halo Orthosis

Neurosurgery ◽  
1987 ◽  
Vol 20 (1) ◽  
pp. 27-30 ◽  
Author(s):  
Michael L. Goodman ◽  
Paul B. Nelson
Keyword(s):  
Cervical Spine ◽  
Brain Abscess ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Radiographic Appearance ◽  
Facet Dislocation ◽  
Spine Injuries ◽  
Brain Abscesses ◽  
Halo Orthosis

Abstract We report a case of brain abscess complicating the use of a halo orthosis in the treatment of a cervical spine injury suffered during wrestling. Four previous brain abscesses complicating the use of halo orthoses have been reported. All cases of abscess have been associated with overlying infection at the site of pin insertion. Our case and at least one of those previously reported may have been related to tightening of the halo pins after placement. Serious spine injuries occur rarely in wrestlers and are associated with the use of illegal holds and maneuvers in which one athlete is thrown to the mat. The pathophysiology and radiographic appearance of a unilateral facet dislocation are reviewed.

scholarly journals Acute traumatic unilateral cervical C4–C5 facet dislocation in pediatric toddlers

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Wongthawat Liawrungrueang ◽  
Rattanaporn Chamnan ◽  
Weera Chaiyamongkol ◽  
Piyawat Bintachitt
Keyword(s):  
Cervical Spine ◽  
Neurological Deficit ◽  
Closed Reduction ◽  
Motor Vehicle ◽  
Rehabilitation Program ◽  
Spine Injury ◽  
Neck Muscle ◽  
Cervical Spine Injuries ◽  
Facet Dislocation ◽  
Cord Injury

Abstract Background The present study is to highlight the challenges in managing cervical spine injuries in toddlers (less than 4 years of age) without neurological deficit. Cases of unilateral cervical C4–C5 facet dislocation in toddlers are very rare. Case presentation A 3-year-old girl suffered cervical spine injury after a motor vehicle collision with unilateral C4–C5 facet dislocation without neurological deficit. Magnetic resonance imaging (MRI) showed no spinal cord injury, Frankel grade E. Initial management was cervical spine protection. Definite treatment and complication were discussed with the patient’s parents before closed reduction maneuver with minerva cast was applied under sedation. The patient showed no complication after closed reduction and the cervical spine had aligned well in radiographs. The minerva cast was removed at 8 weeks, at which point neck muscle stretching rehabilitation program started. At one-year follow up, the child was asymptomatic, had full active cervical motion and good function. In radiographs, the cervical spine had normal alignment and was healed. Conclusions Unilateral cervical facet dislocation in toddlers is very rare. Closed reduction maneuver and the minerva cast applied were optional in this case. The parents were highly satisfied with the effective treatment and outcome.

scholarly journals Anterior-Alone Surgical Treatment for Subaxial Cervical Spine Facet Dislocation: A Systematic Review

2020 ◽  
pp. 219256822090757
Author(s):  
Wendy Lee ◽  
Chung Chek Wong
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Open Reduction ◽  
Meta Analysis ◽  
Fracture Dislocation ◽  
Facet Dislocation ◽  
Subaxial Cervical Spine ◽  
Mesh Terms ◽  
Facet Fracture ◽  
Cervical Facet

Study Design: Systematic review. Objective: Anterior-alone surgery has gained wider reception for subaxial cervical spine facets dislocation. Questions remain on its efficacy and safety as a stand-alone entity within the contexts of concurrent facet fractures, unilateral versus bilateral dislocations, anterior open reduction, and old dislocation. Methods: A systematic review was performed with search strategy using translatable MESH terms across MEDLINE, EMBASE, VHL Regional Portal, and CENTRAL databases on patients with subaxial cervical dislocation intervened via anterior-alone approach. Two reviewers independently screened for eligible studies. PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) flow chart was adhered to. Nine retrospective studies were included. Narrative synthesis was performed to determine primary outcomes on spinal fusion and revisions and secondary outcomes on new occurrence or deterioration of neurology and infection rate. Results: Nonunion was not encountered across all contexts. A total of 0.86% of unilateral facet dislocation (1 out of 116) with inadequate reduction due to facet fragments between the facet joints removed its malpositioned plate following fusion. No new neurological deficit was observed. Cases that underwent anterior open reduction did not encounter failure that require subsequent posterior reduction surgery. One study (N = 52) on old dislocation incorporated partial corpectomy in their approach and limited anterior-alone approach to cases with persistent instability. Conclusions: This systematic review supports the efficacy and success of anterior reduction, fusion, and instrumentation for cervical facet fracture dislocation. It is safe from a neurological standpoint. Revision rate due to concurrent facet fracture is low. Certain patients may require posteriorly based surgery or in specific cases combined anterior and posterior procedures.

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